Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, the expectant mother visited the ER after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she lived in a shed she had built in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and get high.”
She had consumed opioids before arriving at the hospital and had only a brief window to get treated before she had to return to use once more. She thought she still had four weeks left to find a way to become sober and give birth.
The medical professional intervened. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
After five days, on 12 November 2022, Stephanie delivered a baby girl weighing a small weight – premature, tiny yet healthy.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her pain relief did not work, her last dose of fentanyl had been provided a few hours prior to birth.
She felt unwell. Ill-equipped for parenting. Undeserving.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she failed. She felt without value, blaming herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her source would not provide to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her stop using only led to increased guilt and self-abuse, a impetus for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie at last met her, she was attached to tubes and leads, so tiny she thought she would harm her. Cradling her initially, she felt nothing. “I gazed upon her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to call her daughter Izzie, after the professional who provided support to her.
Hospital staff told her about a specialized facility, a new kind of care center where women and their babies are treated together, not apart.
In numerous states, where a baby is identified with neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a developing system of centers like this facility is proving a simple point: when parents and infants remain united, recovery succeeds, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After verifying her eligibility for the program, a couple of employees came to pick her up.
She stepped out of the hospital still in recovery, anxious and doubtful about what would come next.
At the facility, Stephanie still feared that CPS would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any time, someone could enter and separate them.
For the beginning period, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about getting by. Substances came first; trust came last.
Stephanie had one close friend, but even that connection was tenuous. The individuals she cared for always found ways to cause pain. She was unable to love herself, much less anyone else.
Daily, staff from the facility transported her to a recovery program, given as medication. Slowly, she was beginning recovery.
She devoted all her time outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed feeding therapy. She also had increased sensitivity and required an specialist – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I could do this. I could be a mom.
During a pre-holiday visit, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a recovery coach, stopped by with her own family in tow to deliver baked goods. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a decoration on her head, resting on the floor with the exit nearby. She is thin. Her head is tilted forward so you cannot see her face. She is presenting her daughter on her knee for the young ones to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the moms: “What about the fathers?” The moms tried to explain that the men were occupied, engaged elsewhere, that they would be there if they could.
“In the future,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I could be a mom.”
Approaches for managing infants affected by substances have been used for a long time.
The assessment tool was established in 1975|
